- There are still many uncertainties about the long-term impact of HRT on body tissues. Research is under way, but definite answers will not be available until around the year 2000.
- Breast cancer risk may be increased by 30 to 80 per cent in women using HRT for ten years or more. If such a risk does occur (and this is controversial), their risk would rise to about one in ten, compared with about one in fourteen for similar women who do not use HRT. Women whose risk is at the higher end of the range arc those who have a strong family history of breast cancer, a previous breast cancer, or abnormal cells in a breast biopsy.
- The risk of endometrial cancer is five to ten times higher for women with a uterus taking oestrogen alone for more than five years, compared with similar women not on HRT. This increased risk docs not apply where vaginal oestrogen is used according to medical instructions, or when adequate oestrogen and progestogen are used by women with a uterus.
- There is a slight increase in gall bladder disease.
- Uterine fibroids and, rarely, endometriosis may bleed heavily with HRT, especially in women on implants.
- Breakthrough bleeding is a common problem with some regimens of HRT.
- Nausea, breast tenderness, weight gain and skin reactions may also occur, necessitating a change in dosage or in the way the hormone is given.
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